Positron-emission tomographic study of human amblyopia with use of
defined visual stimuli
Source: J AAPOS
1997 Sep;1(3):158-171.
Author: Demer JL, Grafton S, Marg E, Mazziotta JC, Nuwer M PubMed ID: 10532779
Abstract:
PURPOSE: The purpose of this study was to use positron emission
tomography (PET) to evaluate effects of amblyopia on cerebral blood flow
and glucose metabolism in humans viewing defined visual stimuli and to
correlate these effects with specific behavioral and electrophysiologic
measures of visual function. METHODS: One subject with normal vision and
five patients with amblyopia were prospectively studied. During
monocular viewing of a checkerboard reversal stimulus by each subject,
we performed PET imaging of relative cerebral glucose metabolism with
use of [18F]fluorodeoxyglucose, PET imaging of relative cerebral blood
flow with use of H2(15)O, and visual evoked potentials. Control studies
were also performed with use of binocular occlusion and during
presentation of stationary and horizontally drifting checkerboards.
These data were correlated with letter acuities and contrast sensitivity
functions for each eye. RESULTS: Although spatial resolution was
superior for glucose metabolic imaging, PET readily demonstrated
activation of calcarine cortex with use of both metabolic and blood flow
tracers. Even in patients with mild amblyopia, functional activation of
calcarine cortex was reduced in amblyopic eyes compared with sound eyes
to a degree more closely correlated with visual acuity than were visual
evoked potential amplitudes to the same stimulus. When responses to
drifting versus stationary stimuli were compared, a putative motion
processing center was identified in the right temporoparietal region.
Activity in this motion center was relatively preserved during viewing
of drifting stimuli by the affected eye of an anisometropic amblyopic
subject, but was attenuated during viewing of the same stimulus by the
affected eye of a strabismic amblyopic subject. CONCLUSIONS: PET imaging
of blood flow and metabolism can quantitatively evaluate functional
deficits resulting from amblyopia in striate as well as extrastriate
visual areas. Calcarine cortical function correlates closely with
severity of amblyopia, but function in a putative motion processing area
may vary according to the type of amblyopia present